Pre-insulin medication, type 2

Solar said:

However he was reluctant as he regarded Januvia as still new. I've spoken to the hospital unit who do trial it and agree that it may be worthwhile before beginning insulin.

Many thanks.

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Januvia (Sitagliptin) is not new.......it has been around since 21/03/2007 when it was granted a licence for use in the UK/EU. How long does your Dr and Hospital need before they get aquainted with all the anti-Diabetic drugs around for prescribing ? :?

It has been used for mono, dual and triple therapy. There have been many discussions on here before......if you search for Januvia OR Sitagliptin you should be able to find the threads easily. From what I recall most users have found it quite effective, especially if combined with dietary adjustments.

Welcome to the Forum BTW.......

Hi

I have had 'type 2' since 2004 and have been on both Metformin & Gliclazide maximum dose for most of that time. Neither have been that effective for me although have helped. Until recently I low-carbed and kept portion sizes down to keep my BS down. A few weeks back I had some heated discussion with my GP (I asked to go onto insulin due to my peaks going up to 15). My GP said insulin was a 'last resort' for type 2s hence we discussed adding a glitazone or a gliptin. I wasn't keen on glitazones due to bad press about heart related effects hence my GP prescribed Sitagliptin (Januvia). She said it would take up to 6 months to have a real effect. Well, it worked within 2 days! My measurements show that it has removed all my peaks 2 hours after a meal and I never now go over 10. I've been able to eat more than before so I'm really pleased with Januvia. Although my GP suggested I might need to reduce my Gliclazide to avoid hypos I still don't go near hypo BS levels. There are some possible side effects as for all these drugs. I did get headaches during the night for a few weeks but these have now gone and I have no other side effects I'm aware of. Note that Januvia is expensive and most PCTs appear to ask GPs to avoid it and go for glitazones or insulin for 3rd level treatment. The interesting thing with Januvia is that I'm expecting my HBA1c to not go down that much as it removes the dangerous peaks but not the lower average levels hence it is a more effective drug at least for me that an HBA1c measurement might indicate. I hope this info helps just a bit.

I had been taking Metformin & Gliclazide for some years then my BG started to creep up
both Metformin & Gliclazide slowly raised to keep in pace with BG levels,
When on max dose of both, I asked my GP if i could to try Byetta.
Informed my Gp I did Not wish to go onto insulin ,only as last option
i can not exercise at all (wheels) only one arm is working 100%

Gp then asked if i would try Januvia First

Both Januvia and Byetta are on some PCTs Black list for costs,
That may be your GPs real concern :?:
GPs Now have to Justify the use of PCT Black list Medacation

I take all three Metformin Gliclazide Januvia
So far I have been happy with it, I have had No side effects ,my BG so far are Very good

Bob

I had just agreed with my DSN that as my HBA1C was at least stable at 8 we would leave matters as they were as they were unless they went higher . This was nostly because i was very much against going onto insulin although it was practice policy to ge everyone onto insulin sooner rather than later when Idue to an accident I was unable to exercise for months and knew that my next HBA1 C would be sky high.

As bringing my blood sugars down or changing my medication has a drastic effect on my macular oedema I was reluctant to change anything. The only option I was offered would have been one of the glitazones and its cousin Rosiglitazone is credited with causing the macular oedema.
I had never even heard of januvia.

i ook a visit to the hospital 's diabetic clinic organised by my opthamology specialist to have me prescribed januvia as a last resort before insulin.

It worked immediately but did cause hypos so i have been able to reduce my maximum dose of amaryl and may be able to stop taking it alogether. The consultant offered o let me stop it immediately but experience has taught me to be wary f sudden changes o my medicatoion.

I am currenly rying to balance either one or 3 2mg doses daily with exercise. because i still have hypos from time o timee. I think this makes the gP very uncomfortable but to me it is similar
to how insulin users have to treat their diabetes.

I am a little bit worried abou he next hbA!c as I have experienced hypos on several occasions but my levels are now almost always between 4 and 5 with no spikes.

I find Januvia does make me droewsy so I take it in the evenings . occasionally I suffer slight headaches but only for short periods. I was afraid it might nake my hay fever worse as it can cause upper respiraory problems but it has been fine

anuvia and low carbibg with the abikity to exercise again have all the HCP's telling me that I am
a long way from insulin now. I hope that this iis the case for the foreseeable future.

The downside has been that reducing my bg levels has caused increased retinal bleeding. well you can't win them all! I am looking forward to my avastin injecions theis week{not} At least i know what to expect.

All this does make me wonder about he HBA1C/ Ok its he best hey've got but if they want to make it the "be all and ebd all " for t2s then they should be more prepared o accept variations
due to life events and not just react like robots to numbers.

Two years on they are sill holding up as a shining example he 2 very low HBA1c#s which resulted from the rosiglitazone kicking in siddenly {and doing its bes o blind me} Not something I am inclined o applaud I say to because I actually had 2 hnaics within a week of each other because of an admin error . In spite of the fact that I have explained it numerous times hey will persist in alluding o this period as some "golden age" You can' believe how irritating I find it.

Forunately I have my excellent ophalmic consultant to thank for the fact he dreaded rosiglitazone dod not have it all her own way..

I think I am prepared o risk taking Januvia although the long term effects are not yet fullu known/
Although it is expensive if it replaces other drugs and is actually effective it must be worthwhile.